Saturday, 9 December 2017

Below is a redacted version of the email I sent on 9 November 2017 to the Society of Homeopaths (SoH) about some of their registered members. These homeopaths are referencing a treatment whose name alone implies that it can treat autism - CEASE stands for Complete Elimination of Autistic Spectrum Expression. Some of them are making other claims about autism (and other conditions) too.

I am not sure what the SoH can do as it would seem a bit strange for them to ask people to stop using the name of the treatment (but I think it should be renamed), but I hope at least that they'll ask their members not to make other claims about autism at least.

After writing to the SoH I set up a tracker on each of the relevant pages (using https://www.changedetection.com/) which reports back to me if a page has been changed. So far only one page has been in any way amended.

While there are some efforts ongoing to get this inexplicable
accreditation rescinded my main interest is just in getting misleading health
claims removed.

Please don't go looking up the homeopaths' details from the info below and hassling them. It's not really about individual homeopaths but about problems across the entire sector. There are plenty of people making similar claims, these are just some test cases.

-----------------------
Hello

A number of your members seem to be implying on their websites that they are able to eliminate autism.

The use of the term 'CEASE', or worse, writing it out in full ("Complete Elimination of Autistic Spectrum Expression") implies that autism can be 'stopped' or 'eliminated' by following the treatment protocol. This would seem to go against #41 and #47 of your 2015 code of ethics "...No promise of cure, either implicit or explicit, should be made of any named disease...". Also concerning is that some of these websites refer unhelpfully to mistaken anxieties about vaccination and autism. They also make claims about other named health conditions.

I hope that you will consider asking the following people to stop making these implied claims, particularly those about eliminating autism, and look forward to your reply.

Thank you

Jo

1. Homeopath One

"I am a professionally trained classical Homoeopath and registered member of The Society of Homoeopaths."

"The Second Component is ISOTHERAPY which is the homeopathic version of the specific obstacle to cure..."

In the section "What can homeopathy be used for?" a shopping list of conditions is given, the most serious of which include asthma, psoriasis and bronchitis - surely these should be under the care of a GP? No mention is made on that page about seeking medical advice.

December update: no change has been made

Homeopath Two

"I am registered with The Society of Homeopaths, which is the largest organisation registering professional homeopaths in Europe. I practise in accordance with The Society’s Code of Ethics and Practice..."

"I am one of the few specially trained and qualified homeopaths to offer CEASE Therapy (Complete Elimination of Autistic Spectrum Expression) which is a very effective and safe way to treat conditions arising in Autistic spectrum. It combines homeopathy and nutritional supplements alongside a gentle, structured detoxification. This protocol has been not only been successful in treating people on the Autistic Spectrum but also people suffering from a variety of other chronic conditions. For more information about CEASE click [redacted]."

Linked above is [Homeopath 2]'s page about CEASE therapy [redacted link], there are some potentially problematic claims there too

"The treatment of Autism, Autistic Spectrum Diseases and other Modern Diseases with Homeopathy"

"The CEASE approach to treating autism…."

"[Tinus Smits - inventor of CEASE]...successfully treated over 300 autistic children, many of whom totally recovered from autism[emphasis added - what is this meant to imply if not that CEASE can help people 'recover from' autism?]. All of those treated saw improvements in their symptoms and consequently their quality of life and that of their families."

"The CEASE Therapy consists of systematic detoxification and elimination of causative factors that contribute to the illness, which can include vaccinations, medications, environmental toxins." - unhelpfully implying that autism might be linked with vaccinations

"Follow this link to Tinus Smit’s website to read about some of his successful cases: [Official CEASE Therapy website page on successful cases redacted]" - again it is difficult to see how anything other than a cure is implied by this web address and its framing in the text on this website

December update: no change has been made

Homeopath Three

"I am registered with the Society of Homeopaths..."

"I am also a qualified CEASE therapist. CEASE stands for Complete Elimination of Autistic Spectrum Expression and it is a step by step detox program using homeopathic remedies and supplements to remove the autistic qualities. You can read more about it here: [Official CEASE Therapy website redacted]" - other than writing out the term CEASE in full to imply the treatment can 'remove the autistic qualities' this website simply links to a separate website which is much more able to make claims than UK marketers are usually permitted. The linked website repeats the misinformation about links between vaccines and autism.

December update: the reference to their registration with the Society of Homeopaths has been removed.

Homeopath Four

"...I am a fully insured member of the society of homeopaths, working to their strict code of ethics and best practice levels."

"I am also qualified as a CEASE therapist. Cease stands for Complete Elimination of Autistic Spectrum Expression and is an effective way of treating autism through elimination of causative toxic exposures such as vaccines and regular medication."

Another page on this site [redacted link] says

"I BELIEVE HOMEOPATHY TO BE THE MOST POWERFUL AND BALANCING FORM OF MEDICINE AVAILABLE. IT GETS TO THE ROOT OF AN ILLNESS TO ENABLE A LASTING CURE."

Below that is a section on "conditions that patients have consulted" her for which include a number of serious ones such as psoriasis, herpes, thyroid problems and endometriosis.

Saturday, 2 December 2017

This post was originally published on a Woto page but it seems that you can no longer log in with Twitter credentials so instead of trying to update it there I've migrated it here.

When homeopaths go too far

Image from page 205 of "Natural history of birds, fish, insects, and reptiles" (1808)

Reining in the homeopaths

Homeopathy is mostly harmless in that it contains no harmful ingredients (assuming it is prepared correctly, this was not the case for Nelsons in 2012). It is the medical equivalent of 'doing nothing'. But sometimes doing nothing can be a reasonable thing to do (eg 'watchful waiting') but sometimes it's a very bad idea. By taking homeopathic "medicine" people may be under the false impression that they are doing something useful, when instead they need real medicine.

There are a number of examples where organisations, both medical and homeopathic, have had to issue a statement to rein in some of the stranger notion that homeopaths have taken off and run with. Here are some of them.

The World Health Organisation made it clear in July 2014 that homeopathy is of no use for treating Ebola.

The Society of Homeopaths reminds its members, in June 2014, to be careful about the claims made about homeopathy in any marketing material...

The British Homeopathic Association, the Faculty of Homeopaths and the Society of Homeopaths agreed, in April 2013, that people should get their children vaccinated.

The BHA, British Homeopathic Association

"Vaccinations for infectious childhood diseases is currently a major news story. There is no evidence to suggest that the measles outbreak in Swansea or the fall-off in MMR vaccinations in the Totnes area are as a result of people choosing to use complementary medicines instead of conventional immunisation. However, we would like to state that on the issue of immunisation the BHA has for many years taken an unequivocal position.

In line with the Department of Health’s advice, the BHA recommends that immunisation should be carried out in the normal way using the conventional tested and approved vaccines." Vaccinations statement British Homeopathic Association (date not given)

The FoH, Faculty of Homeopathy

"Vaccinations for infectious childhood diseases is currently a major news story.

There is no evidence to suggest that the current measles outbreak in Swansea or the fall-off in MMR vaccinations in the Totnes area are as a result of people choosing to use complementary medicines instead of conventional immunisation. However, as a responsible registering body for statutorily regulated healthcare professionals we again want to make clear our unequivocal and long-standing position on this issue.

In line with the Department of Health’s advice, the Faculty of Homeopathy recommends that in the case of infectious childhood diseases immunisation should be carried out in the normal way using the conventional tested and approved vaccines."

Philip Edmonds, chairman of the Society of Homeopaths said: "The Society does not endorse the use of homeopathic medicines as an alternative to vaccination for the prevention of serious infectious diseases and recommends that members of the public seek the advice of their GP, and/or relevant Department of Health guidelines, concerning vaccination and protection against disease."Parents need to know homeopathy does not protect against measles, says MPThe Guardian 15 April 2013

Public Health England, in February 2011, issued a statement about malaria and homeopathic remedies clarifying that

"The Health Protection Agency Advisory Committee on Malaria Prevention does not recommend relying on any herbal or homeopathic remedies for the prevention of malaria." Guidance: Malaria: Homeopathic Remedies Public Health England 1 February 2011

Dr Peter Fisher, a homeopath, acknowledged in 2011 that homeopathy is of no use in preventing malaria and that fellow homeopaths do themselves no favour when pretending that it does

"So, yes I believe that eventually something, maybe descended from homeopathy, using the key techniques of homeopathy, will be accepted. I have to say I think the homeopathic community is in many ways its worst enemy, particularly in this country [UK]–we have people who make silly claims, frankly, who are not qualified and say things they really shouldn’t say, for instance, about preventing malaria. That is potentially very dangerous and gets us a bad press." An interview with Peter Fisher World of Homeopathy 4 July 2012

Useful as it is to have a senior homeopath acknowledge this @Blue_Wode has pointed me towards this nice quip (curated here on EBM-first, originally posted at Skeptico) from a skeptic, which makes a good point and references similar comments made by Dr Fisher in 2007.

The World Health Organisation made it clear in August 2009 that homeopathy is of no use for HIV, tuberculosis or malaria (or infant diarrhoea, or flu)

"People with conditions such as HIV, TB and malaria should not rely on homeopathic treatments, the World Health Organization has warned."Homeopathy not a cure, says WHO BBC News 20 August 2009

"WHO also said that it does not recommend homoeopathy for treating diarrhoea in infants or flu. WHO experts, who have clearly criticised the use of treatments that have not been proved clinically and that are not evidence based, said that homoeopathy had “no place” in treatment of these five dangerous diseases."WHO warns against using homoeopathy to treat serious diseases BMJ 24 August 2009

Dr Michael Dixon, Medical Director for the Prince's Foundation for Integrated Health also lent his support to the WHO's statement on homeopathy, agreeing that

Thursday, 30 November 2017

NHS England's Board has agreed today with NHS England's recommendations (following a big consultation) that homeopathy should not be routinely prescribed. It should not be prescribed for new patients and prescriptions already happening should be wound down.

Note that this is not a ban on homeopathy. NHS England does not have the legal powers to prevent doctors from prescribing anything that is not on the Department of Health's blacklist (I think in practice it is less a ban on prescribing, more an acknowledgement that it will not be reimbursed which is probably effectively the same). However Section 43 of the document linked above specifically proposes that the Secretary of State should add homeopathy, and several other things, to the blacklist. That would involve a separate consultation and then a decision.

Michael Marshall, Project Director of the Good Thinking Society, said: “We are very pleased to see these recommendations by NHS England, coming two years after we first raised the issue of blacklisting homeopathy to the Department of Health. It is particularly commendable that NHS England took the additional step of actively recommending to that homeopathy be blacklisted. We will be writing to the Department of Health to urge them to take this recommendation seriously and to take swift action." Source.

Well done to the @GoodThinkingSoc team for making sure that homeopathy was part of this consultation. Well done to everyone who submitted their input. NHS England calls for homeopathy to be blacklisted; Enfield CCG ends homeopathy funding https://t.co/x7em5pwdHV

At the time of writing (2pm, 30 Nov 2017) the British Homeopathic Association (BHA) hasn't include any reference to this news in their latest tweets. However over the last few days they have been successfully raising funds to request a judicial review of the process used by NHS England in this consultation. As I understand this is a two-step process - first permission must be given for the review, second the review must take place.

Thanks to @fermi239 for the heads up on Twitter earlier today and thanks also to @zeno001 and @UKHomeopathyReg for further discussion and clarification.

Further reading: this story in the news
As Edzard Ernst noted in July 2017, the tenor of media articles covering NHS funding has generally become much less favourable towards homeopathy, and more favourable (in general) towards a skeptical view of homeopathy than has been seen in previous years. This itself is encouraging - when you want to get something changed it's a lot easier if the prevailing view matches. For a long time it didn't.

Wednesday, 29 November 2017

One of my tasks today has been to let people (teachers in London who've signed up to hear from us) know about our new CPD courses in the New Year. I sent lots of emails and posted on Facebook, and our website, and another website etc etc.

In doing so I shared (by copying and pasting into various posts and emails) four URLs aka web addresses or links

1. A reminder of a free event on robotics for schools at QMUL
https://www.eventbrite.co.uk/e/do-you-want-to-build-a-robot-tickets-39334948891

2, 3 and 4 - for the three computing CPD courses for teachers running at KCL next year.Computing Science and Education: Theory & Practice 2018
https://www1.kcl.ac.uk/prospectus/shortcourses/index/name/csed2018-/alpha//month//day//header_search/computer

Initially I had the four tabs open with the four links 'active'. That's a very efficient way to collect the URLs for pasting into an email or editing window (either as is or more usually hyperlinked beneath text) because the minute you put your mouse cursor into the browser address bar it automatically selects all the URL text (at least it does on Firefox) and you can just Ctrl+C (copy) and Ctrl+V (paste wherever you want it). Peasy.

Sometimes when I've lots of other tabs open - the main website, other website, Tweetdeck, Facebook etc I don't want to have too many additional ones (at time of writing I only have 15 tabs open) so I use Notepad (actually TextEdit on a Mac) and store the URLs there for later collection.

Collection using notepad involves only a little extra effort - I have to position the cursor at one end then click and drag to select the link before placing or pasting it where I want it. For URLs that I visit frequently over a longer period of time I store them in Workflowy (select, copy, paste) or bookmarks (right-click, copy) but that still involves a bit of fiddling about.

I seem to do this sort of task, with multiple URLs, a lot.

What I would love is a 'thing' (as yet unknown) that would let me load up a bunch of URLs and then when I want '1' I click on the '1' and it copies it to my clipboard for pasting, then if I want '3' I click on '3' and so on.

Does this exist? Does it even make sense? How do other people do it? Any ideas? Here's my crappy prototype ;)

This is literally only useful if you're using LOTS of URLs, if one or two then whatever you're doing now is best. So... this could be a grid, doesn't have to be. When text is black you click the number to load your URL and it goes blue. You can then click the blue version to COPY the URL to the clipboard before pasting. Ideally I should have included a bit where you can 'name this URL' so for '1' and '2' here I'd call the first 'robots' and the second 'CSE' etc.

A note on avoiding pasting formatted text
Incidentally these days I paste almost everything into either TextEdit first to get rid of all the formatting (I keep it plain text). If I don't have a background copy open (rare) then I paste it into the address bar of any tab (as long as you don't press enter you're fine) as that's another great way to get the text-only version of any bit of text, doesn't have to be an URL. If I need to collect the address itself then obviously I collect that first before covering it with other text.

The process is (a) carefully select the (formatted) text, Ctrl+C to copy it (b) cursor into address bar and Ctrl+V to paste, (c) Ctrl+A to select all then Ctrl+C to copy the now unformatted text and (d) cursor to destination: Ctrl+V to paste

Tuesday, 21 November 2017

Yesterday (20th Nov) I was surprised to be alerted to a 19th Nov post published on homeopathy enthusiast Sandra Hermann-Courtney’s (@BrownBagPantry on Twitter) blog, a screenshot below.

It turned out to be my blog post (from 15th Nov) copied and pasted without attribution but with a disclaimer stating "No restriction to its unedited re-use for informative purposes was declared." For the record no-one needs to write this on their blog posts, as copyright is implied.

I asked her, through her commenting system, to take the post down and also pointed out that she could have published it unimpeded if she'd interspersed some commentary to at least make it look as if she’s re-using my content as fair use. It is generally OK to publish a line by line rebuttal, it is not OK to steal the content wholesale and publish without attribution (she did include a link to my post). She subsequently did add in commentary and I left her a note saying thanks and that there’d be no further action from me.

So I was surprised to see that she’s edited the same post (at least) three times today. Once to remove it entirely, including two of my comments, with just a link to my post. Then a second time to add in a couple of paragraphs with further bleating and an accusation that I’d threatened her with a DMCA notice to take down her entire blog. You can see exactly what I sent in the screenshots of my comments below (Sandra regularly edits her content after the fact and we’ve all learned to screenshot things in any dealings with her).

Here's the thrilling timeline... dun dun duuun...

Sandra publishes my entire post (losing the links and the formatting, for shame) without attribution and so I send this comment [she published the comment]

Screenshot 1 - click to enlarge

She later adds attribution and announces that the post is ‘editorial’ (it isn’t) and I send this comment [which she doesn’t publish]

Screenshot 2 - click to enlarge

She finally intersperses some comments, for which I thank her in a third comment explaining that no further action will be taken. It was brief and amiable, she might have published it but I forgot to screenshot.

Here’s the text of her post now, as at 7pm 21 Nov, it's already changed several times since 5pm today… her text is in italics, my comments interspersed between.

"UK homeopaths, homeopathy users, supporters, homeopathic organizations, hotels, universities and other venues that host informational gatherings to inform the public about alternative health care options, need to be aware of the content on the blog of JoBrodie "Stuff that occurs to me."

In the first paragraph Sandra focuses on homeopathy but my blog post is about all forms of quackery. In fact my post is specifically only about misleading advertising for quackery. There are numerous talks and events happening every so often in London about homeopathy and I’ve not complained about any of them for the simple reason that they have not claimed they can cure or prevent any disease.

People who are putting together informational events for the public about alternative health may want to make themselves aware of advertising regulations, medicine regulations and the Cancer Act 1939. Trading Standards has shut down a variety of events that would have likely broken the law if they’d continued. Alternative medical folk may detest skeptics but when we point out that something might be a bit dodgy we might actually be saving you a lot of future grief from authorities.

" On one blog page, Brodie describes in explicit detail what and how anti homeopathy skeptics do and can stop educational and/or informational presentations at schools, universities and other organizations. She lists resources for more help as well as successes skeptics have had stopping the informational presentation of alternative health care options, primarily homeopathy. This practice by anti homeopathy activists is dangerous to society. It's bullying. It's disgusting. The title of this blog post reflects my fears in this regard."

"As I interpreted one of Brodie's comments (I deleted them), she threatened to proceed with a DMCA take down notice of my entire blog. I understand how embarrassing this must be to have the skeptics' tactics exposed. Someone has to do it. I did. I will. No regrets."

Sandra has changed this third paragraph several times, this is the current (at 7pm) iteration, two earlier versions are in the tweet below. Edit 22 Nov: she keeps tweaking the post so I've set up an automated change detection to email me when there's been further tinkering ;)

“Threatened [to proceed] with a. DMCA take down notice of my entire blog” - well, see what you think from the text in Screenshot 2 above. I think I’ve included it more as a “well I’d rather not, but it’s an available option isn’t it?” rather than a threat per se, but fair enough it was certainly mentioned. However it then becomes clear that Sandra has panicked somewhat due to misunderstanding what a DMCA notice is. I cannot take down her entire blog, I can only ask for Google (who own Blogger) to remove the content for which I have the copyright. Since I don’t own the copyright for any other content on her blog (to be fair, neither does she as it’s mostly screenshots of other people’s tweets, plus bleating) I cannot have any effect there.

A DMCA notice would likely cost me a couple of hundred pounds as I’d go through a lawyer (to avoid handing over my contact details) and it would also expose me to the mockery of fellow skeptics (and probably a bunch of other people too) for using a sledgehammer to crack a nut - so it’s not something I’d rush into with that much enthusiasm.

The final lines of her third paragraph made me laugh out loud though. It reads as if she thinks I wanted her to take down my post because she was exposing the content to a wider audience. The fact that I’d already published the content to my own blog, then tweeted it and had it further RTed rather suggests I wanted it ‘exposed’ to a wider audience. I just didn’t want it stolen and reposted without attribution. Fortunately she seems to have taken it down. For now...

Admittedly I don’t always succeed in getting people to take content about quackery down, the irony of this success is that the content was my own.

I do hope Sandra isn't cross at me lifting her content and adding my commentary, after all I didn't see anything written on her blog post to indicate the contrary, so I'll assume her agreement since "No restriction to its unedited re-use for informative purposes was declared."

25 November: Edit after she changed her post again
"...someone (perhaps a member of the Society of Homeopaths) in London might want to share a link to her blog with meeting room bookers (www.meetingsbooker.com/uk), institutions of higher learning and health care centers in London."

Quite amazing. This is literally what I want to happen. My post is about gathering information that might be of use to people working in hotels, conference centres or any event bookers wherever they work. The 'end product' from the post should be a set of recommended guidelines on how to spot quackery / misleading health claims and why it's a good idea not to let it flourish by making space available for meetings about it. I'd never heard of meetingsbooker before but if this flags up to them the problem of quackery that's great. She seems to think she's 'exposing' the content on my blog, as if me publishing it and sharing it on Twitter / Facebook etc is somehow keeping it secret. Baffling.

"If the like minded anti homeopathy skeptics need help, Brodie has posted links to the blogs and/or websites of the "Good Thinking Society; the Nightingale Collaboration; Sense About Science and then a Skeptics in the Pub (various around the UK)" where you can, well....learn how to combat the spread of homeopathy over a pint or two..... "

Goodness, how can one person misunderstand so much. The listing of the groups isn't for homeopathy skeptics, or any other kind of skeptics, but for event bookers who are faced with an event they're not sure about and would like to ask someone about it. Those are the people they might ask...